Fri Sep 23 2022

78 articles - From Friday Sep 16 2022 to Friday Sep 23 2022

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Guidelines

Guidelines, position statements, white papers, technical reviews, consensus statements, etc…

Gut

BSG guidelines on faecal immunochemical testing: are they 'FIT' for purpose?

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Meta-analysis

meta-analyses and systematic reviews

Hepatology

Steatosis, HBV-related hepatocellular carcinoma, cirrhosis & HBsAg seroclearance: a systematic review and meta-analysis.

Hepatic steatosis was associated with an increased risk of HCC and cirrhosis among CHB patients, but with a higher chance of achieving a functional cure, highlighting the importance of identifying concomitant steatosis in CHB.

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Original articles

RCT, clinical trials, retrospective studies, etc…

Aliment Pharmacol Ther

Oesophageal secretions reveal local food-specific antibody responses in eosinophilic oesophagitis.

There is a distinct localised profile of immunoglobulins and food-specific antibodies found within oesophageal secretions in EoE. These findings expand our knowledge about the currently identified immune responses in EoE and suggest possible roles for multiple immunoglobulins and food-specific antibodies in the pathophysiology of EoE.

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Safety and efficacy of infliximab and corticosteroid therapy in checkpoint inhibitor-induced colitis.

High prednisolone dose at tapering was associated with increased mortality rate and a high incidence of infections and hospitalisations in patients with severe IMC. We suggest optimised infliximab treatment before escalation of steroid doses.

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The efficacy and safety of adding on or switching to peginterferon a-2b in HBeAg-positive chronic hepatitis B patients with long-term entecavir treatment: A multicentre randomised controlled trial.

In CHB patients who achieved virological response with long-term ETV treatment, both adding on and switching to PEG-IFN therapy are alternative strategies to result in higher rates of HBeAg seroconversion and higher HBsAg reduction compared with continuous ETV monotherapy. Clinical trials registration Chinese Clinical Trial Registry ( identifier ChiCTR-IPR-17012055).

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Validation of the Achalasia Patient-Reported Outcomes Questionnaire.

The APRO is a reliable and valid measure of achalasia symptoms that addresses the limitations of existing questionnaires. Symptom anxiety and hypervigilance moderate the relationship between APRO and quality of life; 33% of patients with achalasia exhibit concerning patterns in symptom severity, anxiety and hypervigilance that may contribute to poorer outcomes.

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Am J Gastroenterol

Assessing the risk of further decompensation and survival in patients with cirrhosis with variceal bleeding as their first decompensation event.

Despite a high incidence of further decompensation, 5-year survival of patients at this stage of cirrhosis is more than 80% across al etiologies in the absence of early further decompensation and active alcohol consumption.

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Changes in Medicare Reimbursement for Common Gastroenterology Services over 15 Years: 2007-2022.

The analysis revealed a steady decline in adjusted reimbursement for both GI procedures and patient visits in the last 15 years.

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Histologic activity in an endoscopically normal appearing pouch predicts future risk of pouchitis in patients with ulcerative colitis.

Histologic inflammation in an endoscopically normal pouch was associated with increased risk of acute pouchitis.

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Humoral Immune Response and Safety of SARS-CoV-2 Vaccination in Pediatric Inflammatory Bowel Disease.

Humoral immune response to COVID-19 immunization in children with IBD was robust, despite a high proportion of this pediatric cohort being treated with immunosuppressive agents. Severe vaccine-related AEs were rare. Overall, these findings provide a high level of reassurance that pediatric patients with IBD respond well and safely to SARS-CoV-2 vaccination.

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Methanogens and Hydrogen Sulfide Producing Bacteria Guide Distinct Gut Microbe Profiles and Irritable Bowel Syndrome Subtypes.

Our findings identify distinct gut microtypes linked to breath gas patterns in IBS-C and IBS-D subjects, driven by methanogens such as M. smithii and H2S producers such as Fusobacterium and Desulfovibrio spp, respectively.

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Patterns of Care Utilization and Hepatocellular Carcinoma Surveillance: Tracking Care Across the Pandemic.

Outpatient utilization and HCC surveillance rates have rebounded but remain below baseline. Population-based approaches and specialty care for cirrhosis were associated with higher completion of HCC surveillance.

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Rapid and Sustained Symptom Relief in Patients With Ulcerative Colitis Treated With Filgotinib: Data From the Phase 2b/3 SELECTION Trial.

Patients in pMCS remission at weeks 10 and 58 had greater improvements in IBDQ score than those not in pMCS remission. CONCLUSIONS: Filgotinib 200 mg daily resulted in rapid and sustained improvements in both UC symptoms and HRQoL.

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Risk of juvenile idiopathic arthritis and rheumatoid arthritis in patients with celiac disease: A population-based cohort study.

DISCUSSIONAmong children with CD, JIA develops nearly 3 times as often as it does in the general population, and among adults with CD, RA occurs nearly 2 times as often. Clinicians caring for CD patients with joint symptoms should have a low threshold to evaluate for JIA or RA.

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Clin Gastroenterol Hepatol

Acute Hepatitis B Virus Infection in North American Adults.

ClinicalTirals. gov number NCT01263587.

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Asia-Pacific Colorectal Screening Score Combined with Stool DNA Test Improves the Detection Rate for Colorectal Advanced Neoplasms.

The APCS score combined with a stool DNA test significantly improved the detection of advanced colorectal advanced neoplasms, while limiting colonoscopy resource utilization. (Chictr.org.cn, ChiCTR-DDD-17011169).

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Bile duct colonization with Enterococcus sp. associates with disease progression in Primary Sclerosing Cholangitis.

The novel association of biliary colonization by Enterococci with disease progression underlines the importance of microbiota-mucosal interplay for the pathogenesis of PSC. These results should stimulate further mechanistic studies on the role of microbiota in PSC and highlight potential new therapeutic targets for a disease without effective treatment options.

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Effectiveness and safety of colonic and capsule fecal microbiota transplantation for recurrent Clostridioides difficile infection.

Cap-FMT using freeze dried capsules has a similar safety and effectiveness profile compared to colo-FMT, without the procedural risks of colonoscopy. While highly effective overall, patient selection is a key factor to optimizing FMT success.

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Esophageal Distensibility Defines Fibrostenotic Severity in Pediatric Eosinophilic Esophagitis.

Esophageal distensibility determined by EndoFLIP is a measure of fibrostenotic severity that can be used to clinically phenotype pediatric EoE. We propose parameters of DI<4.5 mm2/mmHg for defining esophageal rigidity in pediatric patients with EoE ages 9 years and older.

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Initial impact of national CRC screening on incidence and advanced colorectal cancer.

Five years after the start of a nationwide CRC screening program, a decrease in stage II and IV CRC incidence was observed. Patients with screen-detected stage III and stage IV CRC had less extensive disease and improved survival compared to those with clinically-detected CRC.

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Using Natural Language Processing to Automatically Identify Dysplasia in Pathology Reports for Patients with Barrett's Esophagus.

NLP yielded a high degree of sensitivity and accuracy for identifying dysplasia from diverse types of pathology reports for patients with BE. The application of this algorithm would facilitate research and clinical care in EMR system with text reports in large data repositories.

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Gastroenterology

Molecular markers of response to anti-PD1 therapy in advanced hepatocellular carcinoma.

IFN-signaling and MHCII-related genes are key molecular features of HCCs responding to anti-PD1. A novel 11-gene signature predicts response in frontline aHCC - but not in patients pre-treated with TKIs. These results have to be confirmed in prospective studies and highlight the need for biopsies prior immunotherapy to identify biomarkers of response.

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Th17 cell-derived amphiregulin promotes colitis-associated intestinal fibrosis through activation of mTOR and MEK in intestinal myofibroblasts.

These findings reveal that Th17-derived Areg promotes intestinal fibrotic responses in experimental colitis and human CD patients. Thereby, Areg might, serve as a potential therapeutic target for fibrosis in CD.

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Gastrointest Endosc

Incidence and Natural History of Gastric High-Grade Dysplasia in Patients with Familial Adenomatous Polyposis Syndrome.

Gastric HGD in FAP may be more common than previously appreciated. The natural history of HGD is variable, and most patients with HGD do not appear to progress to gastric cancer.

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Gut

Biopsy and blood-based molecular biomarker of inflammation in IBD.

Transcriptionally based scores provide an alternative objective and deeper quantification of intestinal inflammation, which could augment current clinical assessments used for disease monitoring and have potential for predicting therapeutic response and patients at higher risk of disease flares.

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GATA4 and GATA6 loss-of-expression is associated with extinction of the classical programme and poor outcome in pancreatic ductal adenocarcinoma.

cooperate to maintain the classical phenotype. Our findings provide compelling rationale to assess their expression as biomarkers of poor prognosis and therapeutic response.

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Mass cytometry-based peripheral blood analysis as a novel tool for early detection of solid tumours: a multicentre study.

Our study proved that the alterations of peripheral immune cell subsets could assist tumour detection, and provide a ready-to-use detection model for HCC and PDAC.

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Vessel and tissue recognition during third-space endoscopy using a deep learning algorithm.

Applied to standardised video clips from third-space endoscopic procedures, the algorithm showed a mean vessel detection rate of 85% with a false-positive rate of 0.75/min. These performance statistics suggest a potential clinical benefit for procedure safety, time and also training.

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Hepatology

CD8+ T cell memory is sustained in mice by hepatic stellate cells.

Liver, the largest organ of the body, is endowed with the capability of effectuating long-lasting functional cytotoxic T cell memory.

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Combinatorial targeting of GPBAR1 and CYSLTR1 reveals a mechanistic role for bile acids and leukotrienes in drug induced liver injury.

By genetic and pharmacological approaches, we demonstrated that GPBAR1 and CYSLTR1 mutually interact in development of DILI. A combinatorial approach designed to activate GPBAR1 while inhibiting CYSLTR1, reverses liver injury in models of DILI.

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Diagnostic and prognostic performance of urinary Neutrophil Gelatinase-associated Lipocalin in patients with cirrhosis and AKI.

uNGAL is an adequate biomarker for making differential diagnosis of AKI in cirrhosis and predicting the response to terlipressin and albumin in patients with HRS-AKI. In addition, it is an independent predictor of in-hospital mortality.

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Glycemic burden and the risk of adverse hepatic outcomes in patients with chronic hepatitis B with type 2 diabetes.

High glycemic burden was associated with HCC development and fibrosis progression among patients with CHB+T2D, highlighting the importance of glycemic control in reducing liver-related complications.

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Interleukin-33 facilitates liver regeneration through serotonin-involved gut-liver axis.

Our study identified IL-33 is pro-regenerative in a non-injurious model of liver resection. The underlying mechanism involved IL-33/ST2-induced increase of serotonin release from enterochromaffin cells to portal blood and subsequent HTR2A/p70S6K activation in hepatocytes by serotonin. The findings implicate the potential of targeting IL-33/ST2/serotonin pathway to reduce the risk of post-hepatectomy liver failure and small-for-size syndrome.

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Melanoma Differentiation Associated Gene-9/Syndecan Binding Protein (MDA-9/SDCBP) Promotes Hepatocellular Carcinoma (HCC).

Alb/MDA-9 is the first mouse model with MDA-9 overexpression in any tissue type. Our findings unravel a novel HCC-promoting role of MDA-9 mediated by NF-B and Spp1, and support the rationale of using MDA-9 inhibitors as a potential treatment for aggressive HCC.

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Serum Bile Acids as a New Prognostic Biomarker in Biliary Atresia Following Kasai Portoenterostomy.

Serum bile acid levels may be a useful prognostic biomarker for infants achieving normalized bilirubin levels after KP.

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Urine Is a Viral Antigen Reservoir in Hepatitis E Virus Infection.

Our findings demonstrated the origin and diagnostic value of urine Ag and provided insights into the disposal of exogenous protein of pathogens by the host kidney.

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Neurogastroenterol Motil

Effects of Simo decoction on gastric motility of diabetic rats.

Simo decoction improved gastric dysmotility of diabetic rats possibly by upregulating SP and downregulating VIP and nNOS.

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Global patterns of prescription pain medication usage in disorders of gut-brain interactions.

14.8% of patients globally with at least one diagnosis of DGBI were on prescription pain medications with wide geographic variation, about twice as many as their counterparts without a diagnosis of DGBI. Environmental, sociodemographic, and individual factors may influence clinicians to consider personalized, multimodal approaches to address pain in patients with DGBI.

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Using high resolution manometry impedance to diagnose upper esophageal sphincter and pharyngeal motor disorders.

P-HRM-I can provide evidence for UES disorder based on pharyngeal pressurization patterns and abnormal findings for UES relaxation pressure, UES opening, and intrabolus pressure. Measuring pharyngeal contractility requires further optimization.

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Reviews&Editorials

Plenty of the editorials are available as full text through the publisher website using the provided link

Gastrointest Endosc

Prevention of clinically significant post-EMR bleeding: To clip or not to clip?

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Gut

Diet fuelling inflammatory bowel diseases: preclinical and clinical concepts.

Establishing evidence-based dietary therapy for IBD does not only hold promise to avoid long-term immunosuppression, but to provide a widely accessible therapy at low cost. Identification of dietary culprits disturbing gut health also bears the potential to prevent IBD and allows informed decision making in food politics.

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Hepatology

Editorial: It's not all about the virus - on the importance of modifiable lifestyle factors in the development of hepatocellular carcinoma in chronic hepatitis B.

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Modifiable risk factors for fatty liver disease: time to act.

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TIPS in PHT : How to go further while staying on track ?

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J Hepatol

Antisense oligonucleotides (ASOs) in chronic hepatitis B infection: Opportunities and challenging the orthodoxy.

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Immunobiology of the biliary tract system.

Recent technological breakthroughs now permit spatiotemporal assessments of immune cells within distinct niches and have increased our understanding of immune cell tissue residency. In this review, a comprehensive overview of emerging knowledge on the immunobiology of the biliary tract system is provided, with a particular emphasis on the role of distinct immune cells in biliary disorders.

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Loss of liver function in chronic liver disease: an identity crisis.

Moreover, we present compelling experimental evidence demonstrating that restoration of core TFs expression in a chronically injured liver can reset hepatocellular identity, improve function and ameliorate the organ's histology. The possibility of correcting the phenotype of severely damaged and malfunctional livers may open new therapeutic opportunities for patients with cirrhosis and advanced liver disease.

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Neurogastroenterol Motil

Dr. Jeffrey L. Conklin memoriam.

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Miscellaneous

misc publications eg case reports, tools of the trade, images of the month, etc…

Am J Gastroenterol

DIAGNOSIS AND MANAGEMENT OF GASTROPARESIS.

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Emerging Tools for Hepatocellular Carcinoma Surveillance.

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Metabolic syndrome and estrogen use are important confounders in the multifactorial analysis of colorectal cancer risk.

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Pancreatic acinar cell carcinoma projected from the ampulla of Vater with extensive intraductal tumour growth.

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Clin Gastroenterol Hepatol

Endoscopy Training in the Age of Artificial Intelligence: Deep Learning or Artificial Competence?

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Leveraging a new ICD-10 diagnosis code to characterize hospitalized patients with primary sclerosing cholangitis.

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Leveraging Social Media to Enhance Recruitment Efforts in Fellowship Training Programs.

Pubmed   Journal   ReadQx   PMC

Meeting Summary: 2022 American Gastroenterological Association-Center for Gastrointestinal Innovation and Technology Tech Summit.

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Endoscopy

Fix it and feel free to work: endoscopy beside the stent.

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Novel and safe plastic stent exchange method after endoscopic ultrasound-guided hepaticogastrostomy with incomplete fistula (side hole method).

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Peroral endoscopic myotomy after transjugular intrahepatic portosystemic shunt and variceal embolization for a patient with achalasia and esophageal varices.

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Texture and color enhancement imaging facilitates the identification of pancreatic and bile duct orifices after endoscopic papillectomy.

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To register and report is good for the science of endoscopy.

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Use of a bougie-shaped cap for dilation with direct visual control for an esophageal stricture induced by radiation therapy.

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Gastroenterology

Inflammatory Bowel Disease is Associated with Prediagnostic Perturbances in Metabolic Pathways.

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Minimal risk of drug-induced liver injury with molnupiravir and ritonavir-boosted nirmatrelvir.

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Gastrointest Endosc

Everted diverticula with endoscopic mucosal changes mimicking serrated lesions.

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Gut

Seronegative coeliac disease and non-coeliac enteropathies: precision medicine, precision medicine, where are you?

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Hepatology

Hepatology highlights.

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J Hepatol

From the Editor's Desk...

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Letters&Replies

Letters to the editors and authors’ replies

Clin Gastroenterol Hepatol

Reply: TIPS in patient with Hepatocellular carcinoma, is there an indication?

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Gastrointest Endosc

Disposable endoscopes: need for clarity on environmental impact and absolute indications.

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Sedation during EUS-guided portal pressure gradient measurement: the elephant in the room.

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Gut

SARS-CoV-2 Omicron variant infection was associated with higher morbidity in patients with cirrhosis.

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Steps forward in understanding gastric cancer risk.

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Hepatology

Response to 'Letter to the Editor: HuR in Liver Homeostasis' by G. Way.

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J Hepatol

Authors Reply.

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Bepirovirsen / GSK3389404: antisense or TLR9 agonists?

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In situ detection of vaccine mRNA in the cytoplasm of hepatocytes during COVID19 vaccine-related hepatitis.

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The association between liver fibrosis and cognitive impairment in type 2 diabetes.

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